PURPOSE: To prospectively evaluate accuracy of multi-detector row computed tomographic (CT) images for preoperative staging of gastric cancer by using surgical and histopathologic results as reference standards. MATERIALS AND METHODS: This study had institutional review board approval; informed consent was obtained from all patients. Multi-detector row CT included acquisition of virtual gastroscopy images after air distention and contrast material-enhanced dynamic transverse and multiplanar reformation (MPR) images after water distention. Fifty-five consecutive patients with gastric cancer (38 men, 17 women; age range, 37-84 years; mean age, 63 years) underwent preoperative CT. All received 6 g of gas-producing crystals before unenhanced CT scanning for gastric distention and virtual gastroscopy. Patients drank 800-1000 mL of tap water to establish a background for dynamic contrast-enhanced CT scans. Images were obtained in late arterial, portal venous, and delayed phases with start delays of 40, 70, and 150 seconds, respectively. All patients underwent surgery. CT findings were compared with surgical and histopathologic results. Differences in accuracy of transverse and MPR images for T and N staging were assessed with the McNemar exact test. Statistical significance was inferred at P < .05. RESULTS: Detection rates of primary tumors with transverse images, MPRs, and combinations of MPR and virtual gastroscopy images were 91% (50 of 55), 96% (53 of 55), and 98% (54 of 55), respectively. Overall accuracy in assessment of tumor invasion of the gastric wall (T stage) was significantly better with MPR images (89% [49 of 55]) than with transverse images (73% [40 of 55]) (P < .01). Overall accuracy for lymph node (N) staging was 78% (43 of 55) with MPR images and 71% (39 of 55) with transverse images. This difference was not significant (P = .103). CONCLUSION: Multi-detector row CT with combined water and air distention can improve the accuracy of preoperative staging of gastric cancer. MPRs yield significantly better overall accuracy than transverse images for tumor staging but not for lymph node staging. (c) RSNA, 2007.
PURPOSE: To prospectively evaluate accuracy of multi-detector row computed tomographic (CT) images for preoperative staging of gastric cancer by using surgical and histopathologic results as reference standards. MATERIALS AND METHODS: This study had institutional review board approval; informed consent was obtained from all patients. Multi-detector row CT included acquisition of virtual gastroscopy images after air distention and contrast material-enhanced dynamic transverse and multiplanar reformation (MPR) images after water distention. Fifty-five consecutive patients with gastric cancer (38 men, 17 women; age range, 37-84 years; mean age, 63 years) underwent preoperative CT. All received 6 g of gas-producing crystals before unenhanced CT scanning for gastric distention and virtual gastroscopy. Patients drank 800-1000 mL of tapwater to establish a background for dynamic contrast-enhanced CT scans. Images were obtained in late arterial, portal venous, and delayed phases with start delays of 40, 70, and 150 seconds, respectively. All patients underwent surgery. CT findings were compared with surgical and histopathologic results. Differences in accuracy of transverse and MPR images for T and N staging were assessed with the McNemar exact test. Statistical significance was inferred at P < .05. RESULTS: Detection rates of primary tumors with transverse images, MPRs, and combinations of MPR and virtual gastroscopy images were 91% (50 of 55), 96% (53 of 55), and 98% (54 of 55), respectively. Overall accuracy in assessment of tumor invasion of the gastric wall (T stage) was significantly better with MPR images (89% [49 of 55]) than with transverse images (73% [40 of 55]) (P < .01). Overall accuracy for lymph node (N) staging was 78% (43 of 55) with MPR images and 71% (39 of 55) with transverse images. This difference was not significant (P = .103). CONCLUSION: Multi-detector row CT with combined water and air distention can improve the accuracy of preoperative staging of gastric cancer. MPRs yield significantly better overall accuracy than transverse images for tumor staging but not for lymph node staging. (c) RSNA, 2007.
Authors: Francesco Giganti; Elena Orsenigo; Paolo Giorgio Arcidiacono; Roberto Nicoletti; Luca Albarello; Alessandro Ambrosi; Annalaura Salerno; Antonio Esposito; Maria Chiara Petrone; Damiano Chiari; Carlo Staudacher; Alessandro Del Maschio; Francesco De Cobelli Journal: Gastric Cancer Date: 2015-01-23 Impact factor: 7.370
Authors: M Anzidei; A Napoli; F Zaccagna; P Di Paolo; C Zini; B Cavallo Marincola; D Geiger; C Catalano; R Passariello Journal: Radiol Med Date: 2009-09-22 Impact factor: 3.469
Authors: Hye Jin Kim; Ah Young Kim; Jin Hug Lee; Jeong Hwan Yook; Eun Sil Yu; Hyun Kwon Ha Journal: Korean J Radiol Date: 2009-04-22 Impact factor: 3.500